How to Teach in Clinical Settings is a practical guide to support all doctors wishing to develop their skills in clinical teaching and supervision. It provides hands on strategies to address common problems such as giving critical feedback effectively and teaching mixed-level groups. It gives guidance on the particular challenges of teaching in clinical settings including the need to manage teaching with service provision, to engage patients, motivate students, and to judge the balance of support and independence appropriate for each trainee. How to Teach in Clinical Settings is invaluable for all doctors involved in teaching and training at any stage of their career. It is also useful and accessible to medical students who increasingly need to consider and develop their own teaching skills as part of their career progression.
Acknowledgements ix Introduction xi Chapter 1 Creating an effective learning environment 1 Practical ways to create an environment conducive to learning 4 Design of clinical placements 6 Continuity between learners teachers and patients 8 Teaching and learning resources 9 The teaching climate 9 What makes a good clinical teacher? 10 Involving patients in teaching 11 Involving other disciplines in teaching 13 Some principles of effective clinical teaching 15 Useful strategies for clinical teaching 15 Five tips for clinical teaching which do not take time or money 17 References 17 Chapter 2 Teaching in clinical contexts 19 Teaching on ward rounds 19 General principles 19 Useful strategies 21 What you teach unwittingly 23 The psychiatric ward round 25 Handover meetings board rounds and bench rounds 26 Bedside teaching 29 Preparation 29 Structure for bedside teaching 30 Feedback at the bedside 34 Examination practice at the bedside 36 Teaching in clinics 38 General principles 38 Supervising trainees in parallel clinics 40 Effective questioning on presented cases 41 Seeing the patient together 42 Supervising students or trainees who are supernumerary 43 Teaching in the Accident and Emergency department 46 Teaching the interpretation of images/specimens 47 Teaching in theatre 49 General principles 50 Useful strategies 50 Teaching practical skills 56 On-call/remote teaching 60 Teaching patients 62 Teaching other disciplines 64 Further reading on clinical teaching 65 References 66 Chapter 3 Workplace-based assessment and feedback 67 The workplace-based assessments/supervised learning events 67 Using the tools effectively 69 Case-based discussion 71 The mini-clinical evaluation exercise (Mini-ACE in psychiatry) 73 Directly observed procedural skills 75 Multi-source feedback (MSF) 77 Teaching observation tools 79 Giving feedback 81 Giving negative feedback 81 General principles of feedback 82 Useful strategies for giving feedback 82 Feedback models and structures 85 Further reading on assessment and feedback 89 References 90 Chapter 4 Common problems in clinical teaching 91 Balancing teaching and service demands 91 Pitching teaching at the right level 94 Dealing with complaints and clinical incidents 96 Ad hoc teaching 100 Teaching people at different levels together 101 Teaching older or more experienced colleagues 103 Engaging the quiet or reluctant learner 104 The difficult consultation 106 Teaching multiple students 107 Teaching trainees with no interest in your speciality 108 References 109 Chapter 5 Next steps 110 Developing as a teacher 110 Evaluating your teaching 111 Useful resources 115 Appendix Glossary of assessment tools 118 Index 119